Tag: mumps

Partially because I’m an alumnus, and partially because I watch new reports about infectious disease outbreaks all over the world, I’ve been following the recent Syracuse University mumps outbreak. As of 13 November 2017, Syracuse University (SU) Health Services has reported 41 confirmed cases and 78 probable cases of the mumps on the SU campus.

One of the age-old tropes of the anti-vaccine statistics world is that kids who have been vaccinated against the mumps (or measles or any disease) are more likely to get mumps (or any disease) than those who are not vaccinated. I squashed this myth before, but you know what happens – the anti-vaccine zombie tropes tend to reappear over and over and over and over again.

Here we go again, another anti-vaccine trope based on one paper without adequate scientific criticism of said paper. What is this trope? Mumps and measles infections prevent heart disease and stroke. Let me jump right to the conclusion – wrong.

By my calculations, natural infection with the measles and mumps will prevent millions of heart attacks and strokes. Why is this information not all over the TV and internet? I will tell you why. Because mainstream media is in bed with Big Pharma who pay their bills. The politicians are slaves to their corporate masters. Our children should be exposed to every virus and bacteria for which a vaccine exists.

The author’s shrill claim is based on a 2015 article published in the lower impact factor journal, Atherosclerosis. The authors concluded that “measles and mumps, especially in case of both infections, were associated with lower risks of mortality from atherosclerotic CVD (cardiovascular disease).”

Now, it’s time to turn a critical and skeptical eye towards that article.

Mumps and measles infections prevent heart disease – the paper

The study evaluated lifestyle questionnaires from 43,689 men and 60,147 women who were aged 40-79 years at the baseline period of 1988-1990. Individuals of that age probably were not vaccinated against measles or mumps, since that vaccine wasn’t available for children until the late 1960s, when the individuals in the study would have been 20-50 years old. The questionnaire included history of measles and mumps, and were followed until 2009.

The authors then determined hazard ratios (HR, see Note 1) for mortality from cardiovascular disease (CVD) between groups with history of measles and/or mumps infection versus those who did not have those infections. Here are some of the results of the analysis:

Men with history of measles had an HR for all CVD deaths of 0.92.

Men with history of both measles and mumps had an HR for CVD deaths of 0.80.

Women with both infections had an HR for all CVD deaths of 0.85.

The researchers also looked at comparisons between infected and non-infected groups for various types of CVD, but these data probably are the most important.

The study also attempted to show that there was no difference in infected and non-infected groups for a series of confounding variables. They include:

Age

Body mass index

Hypertension

Diabetes

Previous history of CVD

Smoker

Exercise level

Education

Stress level

Taken at face value, the research does seem to support the contention that we shouldn’t get the MMR vaccine to protect ourselves against measles and mumps, because catching those diseases may protect us against cardiovascular disease when we get older. But really, does it really gives us evidence to quit vaccinating? Let’s take look.

There is simply little evidence that measles or mumps is correlated with CVD – a review of PubMed for any articles that might establish a relationship between mumps and/or measles with CVD provided me with two articles. The first is the one we are discussing herein. The second, also published in Atherosclerosis, seems to indicate that mumps and measles is related to higher rates of CVD. This is why cherry picking is bad – you seek out articles that support your pre-conceived conclusion rather than let all of the evidence lead you to a conclusion.

The use of questionnaires for epidemiological studies is frowned upon by many researchers. The reasons for this are many, but they include a reliance upon the memory of the participant for events that may be 50 or 60 years in the past. For a highly infectious disease like measles, it’s hard to believe that 50% of the participants in this survey caught neither mumps or measles as a child. It’s more likely that they actually had caught the disease but forgotten about it. A properly designed study would have measured measles and mumps antibodies then determined the HR. Or used actual medical records (like a lot of vaccine studies use for case control studies of vaccine effectiveness and safety).

The hazard ratios were tiny. Yes, it appears that mumps and measles infections prevent heart disease – the data seem to show a 8-20% reduction in CVD risk. But is that clinically significant? If being vaccinated against measles and mumps showed a 200-300% increase in the risk of CVD, I would be impressed and troubled by the results. But such a tiny reduction in the risk could be explained by anything. A missing confounder. Other infectious diseases. Nutritional levels. In fact, I can go on and on. Furthermore, is an 8% reduction in risk of CVD, if it is valid, worth the risk of death or disabling conditions from contracting measles or mumps? Although the question is rhetorical, it’s actually necessary to come to a conclusion based on the results provided.

Speaking of vaccines, why wasn’t vaccine status asked (although the same memory issues that would plague this questionnaire would still bother me here)? Even though most of the participants probably would have missed the vaccine, some may have gotten it.

The results also showed a 5-20% increase in risk of CVD for women who had either mumps or measles. That result alone throws into question the whole study, because the results are all over the place.

Can one use this article to claim that mumps and measles infections prevent heart disease and stroke? Not really. The best I can say, and I’m doing this with a lot of trepidation, is that this study provides us with observational data, not a confirmation or refutation of a hypothesis about mumps and measles infections. It certainly does not give us any reason whatsoever to change public health priorities in vaccinating against mumps and measles despite the anti-vaccine tropes.

Notes

A hazard ratio describes a ratio of hazard rates between two events. In the case of this study, if the rate of cardiovascular disease mortality for the mumps infected group is 1.0 and it’s 2.0 for the non-infected group, then the hazard ratio is 0.5. That is the mumps infected group is only 50% as likely to have died of cardiovascular disease as the non-infected group.

Lest we forget, vaccines are one of the greatest medical inventions of all time. Without them, we would see cemeteries filled with children who would have died before they were even five years old. In fact, the best evidence we have tells us that vaccines prevented 200 million cases of diseases in the USA alone in the five decades since 1963.

Dr. Hayflick discovered the human cell strain, WI-38, in 1962 which was critical to the safe manufacturing of vaccines, which became widespread in 1963. According to the article, the vaccines produced from the WI-38 cell line prevented almost 4.5 billion occurrences of the diseases, and stopped them from returning to infect us. Dr. Hayflick developed the foundation that allowed the world to have relative safe and very effective tools to prevent infectious diseases.

Prior to the development of WI-38, anti-virus vaccines were grown in monkey cells, which had some issues that made many question their safety, although most of the concern appeared to be overblown. However, once the WI-38 was available, it became easier to develop and produce vaccines for many viruses.

The mumps vaccination program started in 1967 – before that there were about 186,000 cases reported each year (and that number might be low because of underreporting). Once mumps vaccinations were commonplace, the incidence of the disease fell by over 99%. For those who think that better sanitation or whatever caused decreases in diseases, I think that 1967 is fairly recent, and it’s clear that the vaccine itself started the precipitous drop in mumps outbreaks. Since the start of the vaccine era, annual mumps cases in the USA hovered below 1,000 during most years. But over the last 10 years, there has been a noticeable uptick in annual cases, with a high of over 6,000 cases in 2006.

Let’s examine the mumps outbreaks and see what may be the cause. Spoiler alert – expect Andrew Wakefield’s name to appear.

Here we go again. Department of Health Services officials in Arizona have reported that 22 confirmed measles cases in the state associated with a Federal immigration detention facility. This Arizona measles outbreak has one source – Federal employees of that facility who refused to get vaccinated against measles.

In a recent video posted on the Vaxxed website, Andrew Wakefield took those claims head on, mounting a passionate defense of his reputation. If anything, however, this video further shows that Wakefield is not a good source of information.

The video’s claims range from unsupported (and implausible) to blatantly false. Unfortunately for Wakefield, Brian Deer meticulously documented each step in the events, making it relatively easy to identify the problems in these claims. Unfortunately for the rest of us, Wakefield’s adherents are unlikely to check his claims, and others may also accept his word without fact-checking. It’s therefore worth going through the claims.

To hear Wakefield, he was the victim of a conspiracy mounted because he dared raise safety concerns about vaccines. But as with his book, Callous Disregard (pdf), Wakefield’s claims are ill founded. In short, there are good reasons he lost his license and his reputation as a serious scientist.

Since most of those who caught the disease were vaccinated with the MMR vaccine, which protects against measles, mumps, and rubella, the anti-vaccine interwebs are jumping up and down pointing at the pro-science people and saying, “neener neener, vaccines don’t work.” Yeah, they’re that immature. And they are absolutely wrong.

Let’s take a look at the whole story, including some very simple math, which even science deniers should understand. Then we can thoroughly debunk the tropes pushed by the vaccine deniers. This should be fun.

In August 2010 Stephen A. Krahling and Joan A. Wlochowski (“the relators”), former Merck virologists and often called “Merck whistleblowers,” filed suit in the name of the United States – a so-called qui tam action, where the prosecution shares any fines or penalties with the two virologists – against Merck.

There are many canards propagated by the vaccine deniers to support their personal beliefs (really, denialism) about the safety and effectiveness of vaccines. One of their more popular beliefs is that vaccines didn’t end many of the deadly diseases, but improved sanitation, healthcare, nutrition or magical fairies (also known as homeopathy) ended these diseases.

There is even a subgroup of these believers who think that the CDC, historians, and everyone else is lying about the epidemics that existed prior to vaccinations–let’s call this group history deniers. They reject the scientific and historical evidence that vaccines saved lives – amazing.

There are so many silly memes that have arisen from the vaccine deniers, most of which have been thoroughly debunked. Everything from the well-worn (and worn-out) “vaccines cause autism” fable, which I have quashed here, to the “these diseases aren’t dangerous”, which, of course, couldn’t be farther from the truth.

One of the more annoying of the tales pushed by the vaccine refusers is that vaccines aren’t tested thoroughly before being used on unsuspecting infants. I do not know where this started, or why it started, but like much in the anti-vaccination world, it really doesn’t matter. It just passes from one person to another across google, and individuals with no research background hold this particular belief as if it were the Truth™.

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